Abstract
Background
Paget’s disease of the bone (PDB) is a localized disorder of bone remodeling. Nitrogen-containing bisphosphonates (N-BPs) are the treatment of choice.
Aim
We aimed to determine the effectiveness of N-BPs in our practice.
Methods
We prospectively tabulated clinical, imaging and biochemical data as well as interventions.
Results
All patients (n = 31) received one or more different N-BPs such as alendronate, risedronate, and zoledronic acid (ZA). Median (absolute range) serum total alkaline phosphatase (ALP) declined from 302 (55–1,600) to 69 (37–101) IU/L. In a subgroup of patients (n = 18) who received ZA after receiving an oral N-BP, median serum total ALP declined from 197 (44–1, 603) to 65 (37–95) IU/L.
Conclusions
Newly diagnosed patients with PDB should be treated for 6 months with oral N-BPs prior to administration of intravenous ZA. Repeat ZA infusions are necessary only if the serum total ALP levels rise above normal, or if symptoms or complications attributable to PDB persist.
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References
Siris ES, Roodman GD (2008) Paget’s disease of bone. In: Rosen CJ (ed) Primer on the metabolic bone disease and disorders of mineral metabolism. American Society of Bone and Mineral Research, Washington, pp 335–343
Mangham DC, Davie MW, Grimer RJ (2009) Sarcoma arising in Paget’s disease of bone: declining incidence and increasing age at presentation. Bone 44:431–436
Russell RGG, Watts NB, Ebetino FH, Rogers MJ (2007) Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int 19:733–759
Reid IR, Miller P, Lyles K et al (2005) Comparison of a single infusion of zoledronic acid with risedronate for Paget’s disease. N Engl J Med 353:898–908
Langston AL, Campbell MK, Fraser WD, MacLennan GS, Selby PL, Ralston SH (2009) Randomised trial of intensive bisphosphonate treatment versus symptomatic management in Paget’s disease of bone. J Bone Miner Res 25:20–31
Smith D, Murray BF, McDermott E, O′Shea D, McKenna MJ, McKenna TJ (2005) Hungry bones with hypocalcaemia following parathyroidectomy. J Bone Miner Metab 23:514–515
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Mahmood, W., McKenna, M.J. Proposed new approach for treating Paget’s disease of bone. Ir J Med Sci 180, 121–124 (2011). https://doi.org/10.1007/s11845-010-0652-6
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DOI: https://doi.org/10.1007/s11845-010-0652-6